Diabetes Management Strategies in Intensive Care Settings
Critically ill patients often develop hyperglycemia, which is associated with increased morbidity and mortality. Randomized controlled trials have shown that the benefits of tight glucose control (TGC) are context-dependent. TGC reduced morbidity and mortality in patients receiving early parenteral nutrition, using a protocol that included accurate glucose measurements and avoided insulin boluses. Benefit was less pronounced in patients not receiving early parenteral nutrition, which is associated with less severe hyperglycemia. Conversely, TGC caused harm when the protocol induced severe hypoglycemia and glucose variability by inaccurate measurements and insulin boluses. Altogether, evidence suggests to, at least, prevent severe hyperglycemia and hypoglycemia.
Authors
- Rodolfo Javier Galindo (ORCID: https://orcid.org/0000-0002-9295-3225)
- Jan Gunst
- Greet Van den Berghe
- Guillermo E. Umpierrez
Institutions
- University of Miami (US)
- Emory University (US)
- KU Leuven (BE)
Publication Details
- Journal
- Medical Clinics of North America
- Published
- 2026-04-24
- DOI
- https://doi.org/10.1016/j.mcna.2026.01.015
- Primary Topic
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Amgen
- Eli Lilly and Company
- Emory University
- Dexcom
- European Commission
- Vlaamse Overheid
- Fonds Wetenschappelijk Onderzoek
- KU Leuven
- Novo Nordisk
- Vlaamse regering
- European Society of Intensive Care Medicine
- National Institutes of Health
- HORIZON EUROPE Framework Programme
- European Research Council
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Center for Research Resources
- Medical Research Foundation